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How does the antibiotic work? When do you have to take it?

Antibiotics are among the most prescribed medications in modern medicine.

The first antibiotic used was penicillin, accidentally discovered by Alexander Fleming in his laboratory in London. 
Checking the state of a culture of bacteria, he found a layer of mold. 
This event was nothing extraordinary because it was a normal situation, the exceptional thing was the fact that this mold had destroyed all the neighboring bacteria.

Today, there are many different antibiotics to treat infections. 
Antibiotics are able to treat only bacterial infections. 
Antibiotics are useless against:

  • Viral infections (for example, the common cold ),
  • Fungal infections (such as mycosis or  candidiasis ).


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How does the antibiotic work?

Each type of antibiotic affects bacteria in different ways.

Antibiotics can cause:

  • Cell death,
  • Blockade of bacterial proliferation.

There are several types of antimicrobial agents based on the mechanism of action :

  1. Inhibition of bacterial cell wall synthesis (eg penicillins and cephalosporins);
  2. Alteration of cell membrane permeability;
  3. Inhibition of protein synthesis, some antibiotics affect the functioning of the 30S or 50S ribosomal subunits (eg, tetracyclines, macrolides and clindamycin);
  4. Blocking of important microorganism metabolism processes (eg sulfonamides and trimethoprim); 
    When this happens, the bacteria die instead of reproducing.
  5. Blocking of nucleic acid synthesis: DNA and RNA (for example, metronidazole and quinolones).

At the same time, the antibiotic only acts on the mechanisms of life of the bacteria and not on the normal cells.


How to take antibiotics?

The dose of antibiotic can be taken in several ways:

  1. Orally (tablets, capsules, or syrups),
  2. Topically (creams, lotions, sprays or drops),
  3. By intravenous (directly into a vein) or intramuscular injection.

The choice of the pharmaceutical formulation depends on the type of infection :

  • The topical antibiotics are often used to treat skin infections,
  • Those by mouth  can be used to treat most mild to moderate infections.
  • The  intramuscular or intravenous injection is usually reserved for more serious infections.

It is essential to complete the prescribed treatment even if the patient feels better unless a doctor says otherwise because if you stop taking the antibiotic at the beginning, the bacteria can become more resistant.

Before drinking alcohol (beer, wine, etc.) along with antibiotics, you should read the leaflet or consult your doctor as it may cause side effects.


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In most cases, you should not take a double dose of antibiotics to regain the forgotten dose. 
Taking two concomitant antibiotic tablets can cause side effects.

Doctors recommend taking the missed dose as soon as the patient remembersmissing it. 
However, if it is almost time for the next tablet, it is best to wait and skip this tablet. 
In any case, it is advisable to follow the instructions on the package insert containing the information on that particular antibiotic.


Resistance to antibiotics

The ability of antibiotics to cure infectious diseases has led to misuse of these drugs. 
In most European countries, antibiotics are among the most commonly used drugs after analgesics. 
Parents often give the antibiotic tablet to the children when they see mild symptoms. 
Unfortunately, its excessive and inappropriate use in medicine, veterinary medicine and agriculture has resulted in a rapid increase in the frequency of drug resistant micro-organisms.

Many of the early antibiotics have become ineffective or far less reliable than in the past. 
Resistance to antibiotics results in the transfer of genetic resistance characteristics between bacteria of the same species or different species. 
In general, the more you use a specific antibiotic, the greater the risk of developing resistance to the same antibiotic that reduces the effectiveness of the drug.

To avoid this resistance, new antibiotics were created with similar but not identical chemical characteristics , which remain until new resistance phenomena arise. 
The development of new antibiotics is essential to provide effective treatments against infections of particularly aggressive bacteria.


When is the use of antibiotics appropriate?

Antibiotics are effective against bacterial infections and some types of parasites , however they are not effective against:

  • Virus,
  • Fungi.

Taking an antibiotic in case of viral infection does not cure the disease, it only increases the possibility of resistance. 
The basic rules to respect, regardless of the type of infection, for the correct use and to reap the maximum benefits of antibiotics, without endangering or promoting the development of resistant organisms, are three:

  • Take only when really necessary, following the advice of the doctor;
  • Use the right antibiotic, in the right amount, for the entire prescribed period of time;
  • Avoid “do it yourself” even when you think you know how to heal yourself.

Against colds, antibiotics do little or nothing. 
Flu, colds, sore throats and ear infections are almost always caused by viruses and not by bacteria. 
For influenza , the only useful strategies are to rest in a comfortable environment, drink heavily, eat light foods such as fruits and vegetables, ingestion of vitamins and resort to antipyretic fever medicines . 
Antibiotics may be recommended by your doctor, for example:

  1. For those suffering from chronic cardiovascular or respiratory diseases,
  2. To prevent or treat possible secondary bacterial infections facilitated by influenza (in particular, pneumonia).

For colds, never take antibiotics. 
If discomfort is significant, nasal decongestants may be prescribed by the physician for no more than 4-5 days.

The  sore throat , in most cases, is caused by viruses and can be treated with local decongestants. 
Only if it is very intense and associated with bacterial plaques that tend to persist for 2-3 days, despite the use of antipyretics, may need an intervention with antibiotics.

The cough may be just one of the symptoms of the flu or a disease in itself. 
In the first case, the remedies that help are sufficient for therapy:

  • Calming the cough (antitussives),
  • To eliminate excess bronchial mucus (expectorants and mucolytics).

An antibiotic may be needed if there is a risk of a bacterial infection:


How many days do you have to take the antibiotic? When does it take effect?

The antibiotic should be taken during a period that depends on the illness and the condition of the patient. 
Typically, for acute illnesses it takes a cycle of 5/10 days, while for a chronic illness the doctor recommends taking the medication for longer. 
The doctor decides the duration of the therapy based on:

  • In medical history,
  • In the patient’s symptoms.

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